otoplasty Surgery to alter the appearance of the
auricle (external EAR). Otoplasty can be cosmetic
(to improve appearance) or restorative (to treat
congenital deformities or those that result from
trauma and BURNS). The auricle is primarily CARTI-
LAGEand SKIN; the cartilage gives the external ear
its shape and position on the side of the head.
Numerous causes account for abnormalities. Oto-
plasty can remodel the cartilage to alter the size,
shape, and placement of the auricle and even
reconstruct an auricle that is missing or severely
deformed.
See also CAULIFLOWER EAR; PIERCINGS; PLASTIC
SURGERY.
otorrhea A discharge from the EAR. Most com-
monly otorrhea signals the presence of OTITIS, an
INFECTIONof the outer ear (otitis externa) or the
middle ear (otitis media). Otorrhea is normal after
MYRINGOTOMY and placement of tympanostomy
tubes, as the purpose of these procedures is to
drain accumulated fluid from the middle ear.
Drainage that is yellowish green typically contains
pus. Red-tinged discharge contains BLOOD. Either
of these may indicate otitis media with a perfo-
rated TYMPANIC MEMBRANE (RUPTURED EARDRUM).
Drainage that is yellowish brown and thick may
be excessive CERUMEN, often in response to the
ear’s attempts to clear matter from the auditory
canal or to soothe irritated tissues.
Bright bleeding or drainage from the
ear that is watery and clear requires
emergency medical attention.Trauma to the head, such as from a blow or a
fall, can cause outright bleeding from the ear and
may indicate a BONE FRACTURE. Trauma also can
cause CEREBROSPINAL FLUIDto leak into the middle
ear and drain from the outer ear when a perfora-
tion allows the fluid to pass from the middle ear to
the outer ear or from the NOSE(RHINORRHEA) when
the tympanic membrane is intact. Drainage of
cerebrospinal fluid also sometimes occurs follow-
ing surgery to remove an ACOUSTIC NEUROMA; in
any other circumstance it may indicate MENINGITIS.
Treatment targets the underlying cause. ANTIBI-
OTIC MEDICATIONS are necessary when otitis is
responsible. Other conditions such as DERMATITISof
the auditory canal may improve with topical COR-
TICOSTEROID MEDICATIONS. When the drainage is
cerumen, gently rinsing the ears with warm water
during bathing helps remove the excess.
See also CLEANING THE EAR; FOREIGN OBJECTS IN THE
EAR OR NOSE.otosclerosis Abnormal growth of BONE tissue
around the auditory ossicles in the middle EAR,
causing one or more of the ossicles to become
locked into place or fused against the other ossi-
cles. Most commonly affected is the stapes (stir-
rup), the final of the three auditory ossicles in the
sequence of sound wave amplification and trans-
mittal. Conductive HEARING LOSS, which is the pri-
mary symptom of otosclerosis, occurs as
movement of the auditory ossicles becomes
increasingly limited. Occasionally otosclerosis
involves the COCHLEA, causing sensorineural hear-
ing loss and sometimes vestibular dysfunction
such as balance disturbances and VERTIGO.
An AUDIOLOGIC ASSESSMENTidentifies the hearing
loss. The otolaryngologist may request a COMPUTED
TOMOGRAPHY(CT) SCANor MAGNETIC RESONANCE IMAG-
ING(MRI) to visualize the structures of the inner
ear and to confirm the diagnosis. Surgical treat-
ments often can restore conductive hearing loss to
near normal hearing. An OPERATIONto remove the
immobilized ossicle and replace it with a pros-
thetic ossicle can permanently restore hearing in
most people. Surgery is less successful in restoring
hearing loss due to cochlear otosclerosis, though a
HEARING AIDoften can improve hearing.
See alsoSURGERY BENEFIT AND RISK ASSESSMENT;
TINNITUS.otoscopy A basic visual examination of the
outer and middle EARusing an otoscope, a hand-
held, lighted device with a magnifying lens. The
otoscope has cone-shaped tips in varying sizes that
fit into the start of the auditory canal. With an
otoscope, the doctor can examine the auditory
canal for injury, INFLAMMATION, INFECTION (OTITIS
externa) blockages such as foreign objects or com-
pacted CERUMEN, and structural deformities. The
doctor also can visualize the outer surface of the
TYMPANIC MEMBRANE for inflammation, infection,otoscopy 41